Abstract
To determine whether a parent survey linked to physician prompts, using a computer decision support system we have designed (the Child Health Improvement through Computer Automation system, or CHICA), affects physician diagnosis of childhood asthma. A randomized controlled trial was conducted in a primary care pediatric clinic for children aged 3 to 11. An asthma module was added to the CHICA system for the intervention group, where parents were asked about asthma symptoms on a prescreener form. If a parent answered yes, then the physician received a prompt to determine whether an asthma diagnosis was appropriate. In the control group, parents received no screening questions, and physicians received no prompt. Over the study period, 2098 patients were randomized. Excluding those children with a previous diagnosis of asthma in the 14 months before the study, significantly more children in the intervention group were diagnosed with asthma than in the control group (8.6% vs. 5.8%, P<0.02). This study showed that the approach utilized by the CHICA system was effective in increasing physician diagnosis of asthma. Computer decision support systems, like our CHICA system, have much potential for increasing asthma case finding through parent questionnaires and tailored physician guidance. (Clinical Trial Registration: Clinicaltrials.gov, ID number: NCT01312805)
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